moeBSN1988

Thank you. I appreciate the information you provided and will look into it.

Thank you for your response. The challange of finding enough caregivers at $10/hr that you can trust is a huge issue. CNA are a blessing to those in need and it is a shame they are not paid more for what they do. I think higher pay would attract more quality candidates.

Sorry for the late response. I have been on vacation. I really appreciate your support. It is tough out there with blurred boundries and BON unwilling to answer any questions directly due to risk of liability. You are left to determine whay you think the rules and regs are.

Sorry for the late reply. I have been on vacation. Thank you. I will look into it.

I would feel pretty comfortable with just reading up on the current practices as I worked in a GI lab for several years. I want to make sure the BON would consider me competent. Thanks for responding.

Feeding and suctioning is not done in non-medical home health. I am mainly in the office.

I also was approached to be the RN with a home care company that was a start up. I told them I wanted the same rate I was print paid by the hospital and that I wanted to be paid hourly. I wanted to be paid hourly because traffic is a problem where I live. It would take me more hours to make the same amount of money I did at the hospital.

I have the same position and it is very vague what our role is. I started out doing patient assessments and still do some but now am DON and I charge of overseeing close to 100 patients and the CNA's skill Assessments as well as many other rolls. I am also feeling like my nursing judgement is not valued. I have been asked to do CNA training but they don't want to allow me the time to it properly. They don't understand what is involved to comply with regulations and want it done quickly and cheaply. They do not believe that they would be putting my license at risk. It infuriates me that they want me to do a job but don't believe all that is required to comply with regulations. If we can't resolve this issue I will be resigning. I feel your pain. Your job is very important. You are assisting a population of patients that are often not getting the help they need and can be an advocate for them by helping them obtain what services and equipment they need in order to stay in their homes. Many times they just want somebody to listen to them and you may be the only person they talk to all day.

No. That is all me also.

We saw a home health patient woth a foley. Her urologist told cut the port where the water goes in to remove it the morning of day she had an afternoon appointment with him. He wanted to see if she was able to void on her own and if not he would reinsert it at the appointment. I thought it was weird toobut it makes sense and saves a visit.

No, GA and other states have passed a law to allow nurses to teach unlicensed caregivers (CNA's) to provide some nursing tasks in patients homes to lessen somewhat of the burden on families. G tube feedings are one task allowed. There are strict guidelines set up by the state that have requirements for such a program. You must write a curriculum that has competencies,have policies and proceedures on any problems and what to do if they occur, obtain informed consent, have a doctor's order and many other requirements. (Basically you would need to teach them what a nurse needs to know to be considered competent.) Then they would be working under your liciense. The requirements are very vague and the BON has not been helpful. The teaching needs to be more involved than what you teach the family because the person you are teaching is a paid caregiver and so the liability risk is huge should something go wrong. My employer seems to think you just print a check sheet and consent and check them off. This type of client would bring in a lot of money for them. They want to start it in 2 weeks. You would also have to find enough CNA's that you would feel comfortable with to work under your license to cover the case 24/7.

I am DON of a home care company. I over see approximately 100 patients and the CNA's that provide care. I have been asked to do a nurse by proxy case involving g- tube bolus feeds and oral suctioniing. It has been 7 years since I worked in a GI lab and 3 years since I have worked in a hospital. I have researched current practices but what do I need to do to ensure my competency and to be able to teach others? I am very opposed to doing this nurse by proxy program unless it is done correctly to protect the patient and myself. I am being pressured to do this proxy care and am very close to resigning. My employers do not understand that I can't just get a check sheet and check off skills. It doesn't seem to matter what literature I present on the requirements of proxy care in GA. I will resign before I would be forced to do this. Does anybody have any advice?

Thank you for your help.

I have been a RN for a long time and have worked all areas and ages from NICU, Peds ER,GI, PACU and now DON at a home care company. I have always been interested in nutrition, herbal medicine, CAM because they all treat the whole person and don't just treat the symptoms. How do you get started in this area? Where would you find a job with some exposure to begin learning?